| NPI | 1306464169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS T-4505) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MS T-4505) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS T-4505) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT220162) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2021-09-10 |